If you are like most people with COPD, you've probably experienced at least some degree of pain in your chest and ribs. This kind of pain can come in a variety of forms, including muscle aches, rib soreness, chest tightness, and general feelings of discomfort.

Unfortunately, these types of aches pains often don't get the attention they deserve, since discussions about COPD tend to focus on respiratory symptoms. However, research suggests that chest pain is exceedingly common, affecting more than half of people with COPD.

That's why we've created this guide all about chest pain, rib pain, and COPD. It contains all the basics you need to know about COPD-related chest pain, including why it happens, where it comes from, and what you can do to relieve it.

In the following sections, we'll explain the various types of chest pain that COPD can cause, and how to differentiate COPD-related chest pain from from other, more serious causes. Then, we'll show you how to manage and minimize that pain by walking you through nearly a dozen of helpful strategies that you can put to use right away.

What is COPD Chest Pain?

A large percentage of people with COPD experience some type of chest pain, whether it's frequent, chronic, or only just occasional. It can sometimes be difficult to pinpoint the exact source or reason for this chest pain because there are so many potential COPD-related causes.

Some of the most common types of COPD-related chest pain include:

• A general feeling of pressure, squeezing, or tightness in the chest
• Feeling of weight or pressure on the chest
• Chest muscle tightness and soreness
• Pain and soreness in and around the rib cage
• Aching and stiffness in the chest
• Soreness in the chest and/or ribs when breathing
• Feeling of fullness or discomfort in the chest when eating
• Tightness or heaviness in the chest when lying down

Some chest pains are triggered by COPD symptoms like shortness of breath or coughing, while others are related to physical changes (such as lung hyperinflation) caused by the disease. Some types of COPD chest pain tend to get worse in certain situations, such as when you eat, lie down, or experience a COPD exacerbation.

Most sources of COPD-related chest pain are harmless, but some types of chest pain are caused by health problems other than COPD. Certain types of chest pain can even signal a medical emergency like a heart attack.

In the next sections, we'll take a closer look at some of the major causes of COPD-related chest pain, and how to recognize other types of chest pain that might have a more serious cause. Then, in the following sections, we'll introduce you a to variety of practical strategies you can start using today to minimize your COPD chest pain.

What Causes COPD Chest Pain?

Muscle Fatigue

Normally when healthy people breathe, the diaphragm does most of the work required to move air in and out of the lungs. When your breathing is strained by COPD, however, you tend to rely more on the muscles in your chest to breathe.

Because of this, living with COPD tends to wear out your chest muscles, making them feel tired and sore. This soreness can be triggered by coughing fits, bouts of breathlessness, or even normal daily symptoms.

This type of chest soreness tends to get worse along with increasing shortness breath. This can happen during COPD symptom flare-ups and exacerbations, and during activities—like exercise—that are particularly demanding on your lungs.

This type of pain can range anywhere from mild to severe. For some people with COPD chest pain is simply a nuisance; for others, it is a significant source of pain that makes it even more difficult to breathe.

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Lung Hyperinflation

Lung hyperinflation describes lungs that are enlarged and take up more space in your chest than they should. It is a common COPD complication that tends to get worse as the disease progresses, and it's a major cause of chest and rib pain in people with the COPD.

Lung hyperinflation has a couple of major causes: The first cause is lung tissue damage, which happens gradually over time in lungs affected by COPD. This damage causes normally-stretchy lungs to lose the flexibility and elasticity that allows them to expand and collapse as you breathe.

Eventually, the lungs lose so much of this elasticity that they can't “bounce back” completely from their fully inflated state. This causes your lungs to remain slightly inflated even after you exhale, and it's known as static hyperinflation.

The second major cause of lung hyperinflation is trapped air in the lungs. This happens when airway constriction (often combined with weak and shallow breathing) makes it difficult to empty all the air out of your lungs, causing some of the air you breathe to stay trapped inside.

This leftover air takes up space and leaves less room for fresh, oxygenated air to come into your lungs; this makes your lungs less efficient and worsens shortness of breath. The trapped air also prevents your lungs from collapsing all the way, forcing them to stay partially inflated even after you exhale.

As a result, hyperinflated lungs are bigger, stiffer, and take up more space in your chest compared to healthy lungs. This causes them to press against your chest cavity, putting extra pressure on your ribs, the surrounding muscles, and the ligaments that support all the muscles and bones in your chest.

Because of this, hyperinflated lungs tend to cause a lot of pain and discomfort. This pain can range from sore ribs or aching muscles to a general uncomfortable feeling of pressure or fullness in the chest.

Unfortunately, hyperinflation tends to get worse over time, as the stiffened, expanded lung tissue becomes even more prone to trapping air. Fortunately, it is possible to reduce the symptoms of hyperinflation, even though the actual damage of lung enlargement often can't be reversed without surgery.

With proper treatment and management techniques, you can reduce chest pain caused by hyperinflation and potentially even slow down how quickly the condition gets worse. Treatments include brochodilators, breathing exercises, and other strategies which we will discuss more in the sections below.

Strain on Connective Tissues

The same COPD symptoms that wear out your chest muscles (e.g. coughing and shortness of breath) can also put stress on the ligaments and connective tissues in your chest. These tissues are responsible for connecting and holding everything in your chest in place, including your bones, muscles, lungs, and other organs.

In people with COPD, these connective tissues tend to get stretched and strained by frequent coughing and labored breathing. These tissues are also affected by hyperinflated lungs, which press on your ribs and chest wall, straining all the structures that connect and support them.

This stress on connective tissues can cause a great deal of soreness and pain in the chest and ribs, especially when paired with other symptoms like coughing. COPD can also cause permanent changes to the structure of your chest that could contribute to this pain.

Over time, inflammation caused by the disease can weaken and stiffen the connective tissues surrounding your lungs, making them less elastic and more prone to causing pain. While this phenomenon is not yet fully understood, researchers believe it could be a major contributor to chest pain in people with COPD.

Psychological Illnesses

If you suffer from a psychological illness like anxiety or depression, it can actually make any chest pain you experience significantly worse. However, that doesn't mean the pain isn't real or that it's “all in your head.”

The brain and body are intimately connected, and psychological illnesses can have biological effects that cause real, physical pain, or that amplify pains you already have. This phenomenon is widely recognized by researchers and mental health experts, which is why psychological therapy is a common treatment for chronic pain.

Unfortunately, a very large percentage of people with COPD suffer from depression or anxiety, especially among those with more severe disease. Research shows that these mental disorders can not only worsen COPD-related pains—such as chest pain—but also worsens quality of life and increases patients' risks for disability, hospitalization, and death.

GERD

GERD, which stands for gastroesophageal reflux disease, is condition that causes stomach acid to leak into your esophagus (a phenomenon known as acid reflux). For reasons that are not yet fully understood, GERD is extremely common in people with COPD.

Some researchers believe that the high risk of GERD may be caused by hyper-inflated lungs putting pressure on the abdomen and chest. Others believe that certain COPD medications may contribute to the risk by weakening the barrier that usually stops acid from leaking out of the stomach.

Unfortunately, GERD often causes symptoms that overlap with COPD symptoms, including coughing, shortness of breath, and chest pain. What's worse, GERD can cause stomach acid to leak into your lungs, which can exacerbate existing COPD symptoms and even trigger COPD flare-ups.

Because of this, GERD can be a significant contributing factor in COPD-related chest pain and discomfort. If you think you might have GERD, it's important to talk to your doctor so you can get treatment right away.

Some of the most common symptoms of GERD include heartburn, coughing, lung irritation, throat irritation, and disrupted sleep. Another sign of GERD is burning chest pain that tends to gets worse after eating and after you lie down.

When Chest Pain is an Emergency

Many types of chest pain are generally harmless, including most types of rib and chest muscle soreness caused by COPD. In some cases, however, chest pain can be a sign of a life-threatening emergency like a heart attack, heart failure, or another serious cardiac event.

Unfortunately, the symptoms of major cardiac events vary significantly from person to person and can sometimes be very mild, which makes them difficult to detect. They can also be disguised by other health conditions, like COPD, which has symptoms that mimic and overlap with the same symptoms caused by heart problems.

That's why it's important to be familiar with your COPD symptoms and what kinds of pains and sensations are typical for you. The better you know your disease, the better you will able to detect if something is abnormal or wrong.

You should also know how to recognize the symptoms of a heart attack so you can better differentiate it from other symptoms that are caused by COPD.

Here are the major signs and symptoms of a major cardiac event:

• Chest pain that doesn't go away with rest
• Chest pain that is different or more severe than chest pain you've had in the past
• Pain that spreads from the chest to the left arm, back, or jaw
• Sudden feeling of pressure, tightness, crushing, or squeezing in your chest
• Sudden shortness of breath, especially if it doesn't go away with rest
• Sudden drop in blood pressure
• Extremely slow or rapid heartbeat
• Extremely rapid breathing
• Dizziness or lightheadedness
• Nausea or vomiting
• Sweating
• Weakness or losing the ability to stand or walk
• A sense of impending doom
• Confusion or disorientation
• A family history of heart disease

If you experience these symptoms and have any doubt about whether they are caused by a heart problem or COPD, you should seek medical attention immediately.

There are also some signs you can look for that indicate your chest pain is not related to your heart. However, it's important to realize that having one or more of these signs does not rule out a heart attack completely.

Here are some signs that your chest pain might not be caused by a cardiac event:

• You can pinpoint the specific location of the pain.
• The pain gets worse when you take in a deep breath, and subsides when you hold your breath for a few seconds.
• The pain gets worse when you move in a specific way or press in a specific spot on your chest, neck, or shoulder.
• The pain gets better with medication, such as antacids.
• The pain doesn't last very long and goes away quickly.
• The pain feels identical to pain you've felt before, at a time when you knew for a fact that it was not caused by a heart problem (e.g. chest pain that you had diagnosed as being caused by COPD).

How to Reduce Chest & Rib Pain Caused by COPD

Now that you have a better understanding of how COPD causes chest pain, let's look at what you can do about it. In the following sections, we'll introduce you to a plethora of effective tips and techniques you can use to reduce various types of chest and rib pain related to COPD.

Adjust Your Posture

There's a reason that good posture is considered to be so important in activities that rely on your breath, such as singing, public speaking, and playing wind instruments. The reason is that your posture can have a significant effect on your lung capacity and your overall ability to breathe.

When you sit or stand in a slouched posture, it scrunches up your chest and restricts how much your lungs can expand. This increases the effort it takes to breathe and puts extra pressure on your chest and ribs, which can cause them to become sore.

Good, straight posture, on the other hand, opens up your chest cavity and gives your lungs, diaphragm, and chest muscles much more room to move when you breathe. This relieves some of the strain on your ribs and breathing muscles, reducing chest soreness and other posture-related pain (e.g. back pain, neck pain, and shoulder pain).

The most important aspect of good posture is holding your back up straight, which means avoiding bent positions like hunching and slouching. You should also keep your chin up and your shoulders back while keeping your shoulder muscles relaxed.

You should also practice proper sleeping posture, which can reduce chest pressure and make it easier to breathe when you sleep. Avoid sleeping sitting up, as some people with COPD do, and try to find a comfortable position on your side or back instead.

You should also make sure your back is properly supported both when you sit and when you lie down. Any chairs you sit in often should have lower back support and your mattress should be firm enough to keep your back straight while you sleep.

For more information and advice about posture and COPD, visit our guide on the topic here. You can also check out this guide to learn more about good sleep posture and how to get the best quality of sleep possible with COPD.

Practice Breathing Techniques

As we mentioned earlier, shortness of breath on its own can cause certain types of chest pain, especially muscle soreness. This is partially caused by the natural instinct to take much quicker and shallower breaths when you are struggling to breathe.

This essentially forces your breathing muscles to work overtime, wearing them out more quickly and causing muscle pain. Your muscles also have to work harder to push air through constricted airways, which tend to get even narrower during bouts of shortness of breath.

Fortunately, there is a special breathing exercise you can use when you feel breathless that reduces strain on your chest muscles. This technique, known as pursed lips breathing, works by physically opening up your airways to make it easier to breathe.

The basics of pursed lips breathing are simple: you breathe in through your nose for about two seconds, and then you purse your lips before breathing out. If you're pursing your lips correctly, they should make a small “o” when you exhale, as if you were whistling or blowing a kiss.

Finally, exhale for another four seconds or so, until there's no more air to push out. Make sure you empty your lungs as completely as possible before you take your next breath.

Breathing out in this way creates extra pressure in your airways, which holds your airways open and prevents them from collapsing. This reduces shortness of breath and can also reduce lung hyperinflation by helping you empty all the air out of your lungs.

Pursed lips breathing also helps you learn how to control your breaths, which allows you to slow and steady your breathing rate. This technique is particularly useful for bringing rapid and shallow breathing patterns back under your control whenever you start to feel short of breath.

To learn more about pursed lips breathing and get step-by-step instructions for how to do it, check out our guide on breathing exercises for COPD.

Practice Controlled Coughing

Many people with COPD have lots of extra mucus clogging up their airways, which can cause a chronic cough and painful coughing fits. This kind of uncontrolled coughing can be extremely hard on your chest, causing violent spasms that strain your rib cage and wrack the walls of your chest.

This can lead to muscle soreness, aching, and sharp pain in the ribs that gets worse when you move your chest. It can also make it extremely painful to cough, take breaths in, or make certain motions, and may even interfere with your sleep.

However, you can reduce the pain of uncontrolled coughing by practicing controlled coughing, which is gentler and puts less strain on your chest. It also does a better job than uncontrolled coughing at loosening up mucus and moving it out of your lungs.

Here are the basics of how to do it:

• First, sit down in a comfortable chair, placing your feet flat on the ground.
• Relax your body, fold your arms across your lower abdomen, and lean forward slightly in your seat.
• Inhale slowly through your nose.
• Then, cough by following these steps in order:
• Press your arms against your abdomen
• Lean forward
• Open your mouth and make 2-3 short, sharp coughs
• Make sure you use your diaphragm, not your chest muscles, to force the cough out (your belly should move when you inhale and exhale, while your chest muscles should stay still)
• Immediately take another slow breath in through your nose.
• Take a moment to rest, then repeat.

If you practicing controlled coughing regularly, it can help you breathe easier by clearing out excess mucus that's blocking up your airways. Less mucus also means you'll have less need to cough and likely have fewer coughing fits.

For more information about controlled coughing and how to do it correctly, check out this guide from the Cleveland Clinic. You can also find more ways to reduce coughing and get rid of excess mucus in our guide on mucus clearance techniques.

Improve Your Fitness

Getting regular exercise is absolutely essential for staying healthy with COPD. It helps you stay mobile, independent, and can even improve your COPD symptoms and make it easier to breathe.

Exercise can also improve how efficiently your respiratory system works. It does this primarily by strengthening your heart, strengthening your breathing muscles, and reducing how much oxygen your body needs to do physical activities.

This improves your exercise endurance, allowing you to stay active for longer without feeling too short of breath. It also helps your breathing muscles work better, improving how long and hard they can work before they get tired out.

In this way, exercise can improve COPD-related chest pain by reducing how sore and fatigued your chest muscles get from breathing. It can also reduce strain on those muscles by reducing how often you become breathless and reducing the overall effort required to breathe.

But in order to get these benefits, you need to make a commitment to living an active life. That means exercisin